scholarly journals Hormone replacement therapy in young women with primary ovarian insufficiency and early menopause

2016 ◽  
Vol 106 (7) ◽  
pp. 1588-1599 ◽  
Author(s):  
Shannon D. Sullivan ◽  
Philip M. Sarrel ◽  
Lawrence M. Nelson
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Young Women ◽  
Hormone Replacement ◽  
Primary Ovarian Insufficiency ◽  
Early Menopause ◽  
Ovarian Insufficiency

scholarly journals Optimizing Fertility in Primary Ovarian Insufficiency: Case Report and Literature Review

2021 ◽  
Vol 12 ◽  
Author(s):  
Kensuly C. Piedade ◽  
Hillary Spencer ◽  
Luca Persani ◽  
Lawrence M. Nelson
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Intrauterine Insemination ◽  
Hormone Replacement ◽  
Elevated Serum ◽  
Oocyte Donation ◽  
Reproductive Hormones ◽  
Primary Ovarian Insufficiency ◽  
Ovarian Insufficiency ◽  
Major Mechanism

Primary ovarian insufficiency (POI) is a clinical spectrum of ovarian dysfunction. Overt POI presents with oligo/amenorrhea and hypergonadotropic hypogonadism before age 40 years. Overt POI involves chronic health problems to include increased morbidity and mortality related to estradiol deficiency and the associated osteoporosis and cardiovascular disease as well as psychological and psychiatric disorders related to the loss of reproductive hormones and infertility. Presently, with standard clinical testing, a mechanism for Overt POI can only be identified in about 10% of cases. Now discovery of new mechanisms permits an etiology to be identified in a research setting in 25–30% of overt cases. The most common genetic cause of Overt POI is premutation in FMR1. The associated infertility is life altering. Oocyte donation is effective, although many women prefer to conceive with their own ova. Surprisingly, the majority who have Overt POI still have detectable ovarian follicles (70%). The major mechanism of follicle dysfunction in Overt POI has been histologically defined by a prospective NIH study: inappropriate follicle luteinization due to the tonically elevated serum LH levels. A trial of physiologic hormone replacement therapy, clinically proven to suppress the elevated LH levels in these women, may improve follicle function and increase the chance of ovulation. Here, we report the case of a woman with Overt POI diagnosed at age 35 years. To attempt pregnancy, she elected a trial of intrauterine insemination (IUI) in conjunction with follicle monitoring and physiologic hormone replacement therapy. She conceived on the eighth cycle of treatment and delivered a healthy baby. Our report calls for a concerted effort to define the best methods by which to optimize fertility for women who have POI.

scholarly journals Very low levels of serum anti- Müllerian hormone as a possible marker for follicle growth in patients with primary ovarian insufficiency under hormone replacement therapy

2020 ◽  
Author(s):  
Yukiyo Kasahara ◽  
Satoko Osuka ◽  
Bayasula Bayasula ◽  
Natsuki Nakanishi ◽  
Tomohiko Murase ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Limit Of Detection ◽  
Hormone Replacement ◽  
Primary Ovarian Insufficiency ◽  
Enzyme Linked Immunosorbent Assay ◽  
Follicle Growth ◽  
Ovarian Insufficiency ◽  
Positive Serum ◽  
Low Levels

Abstract Background Patients with primary ovarian insufficiency (POI) occasionally present with follicle growth; however, it is difficult to predict exactly which cycles will show follicle growth. Serum anti-Müllerian hormone (AMH), a useful marker for ovarian reserve, is produced in early-stage follicles. Therefore, AMH levels should reflect the presence of small follicles, which are difficult to detect using ultrasonography, and may be useful as a marker for predicting follicle growth in patients with POI. Methods Using an ultrasensitive enzyme-linked immunosorbent assay (ELISA) kit, we found very low serum AMH levels in patients with POI. We assessed the follicle growth of each patient during each cycle to clarify the usefulness of measuring serum AMH levels for predicting follicle growth in patients with POI under hormone replacement therapy (HRT). Results A total of 91 cycles of 19 patients with POI were analyzed in this study. Five patients presented with positive serum AMH levels during the observational periods, and all five experienced follicle growth. Only two of the 14 patients with negative serum AMH levels had follicle growth. Serum AMH and follicle-stimulating hormone (FSH) levels in cycles with follicle growth were significantly higher than in cycles without follicle growth. The median serum AMH level (2.77 pg/mL; 25 th , 75 th percentiles: 0.0, 9.64) in cycles with follicle growth was lower than the lower limit of detection of conventional AMH ELISA kits. The positive predictive value of positive serum AMH levels for follicle growth was higher than that of FSH (< 10 mIU/mL). Conclusions Measurement of very low levels of serum AMH using picoAMH assays is useful for prediction of follicle growth in patients with POI under HRT conditions.

scholarly journals Very low levels of serum anti-Müllerian hormone as a possible marker for follicle growth in patients with primary ovarian insufficiency under hormone replacement therapy

2020 ◽  
Author(s):  
Yukiyo Kasahara ◽  
Satoko Osuka ◽  
Bayasula Bayasula ◽  
Natsuki Nakanishi ◽  
Tomohiko Murase ◽  
...  
Keyword(s):  
Hormone Replacement Therapy ◽  
Replacement Therapy ◽  
Limit Of Detection ◽  
Hormone Replacement ◽  
Primary Ovarian Insufficiency ◽  
Enzyme Linked Immunosorbent Assay ◽  
Follicle Growth ◽  
Ovarian Insufficiency ◽  
Positive Serum ◽  
Low Levels

Abstract Background: Patients with primary ovarian insufficiency (POI) occasionally present with follicle growth; however, it is difficult to predict exactly which cycles will show follicle growth. Serum anti-Müllerian hormone (AMH), a useful marker for ovarian reserve, is produced in early-stage follicles. Therefore, AMH levels should reflect the presence of small follicles, which are difficult to detect using ultrasonography, and may be useful as a marker for predicting follicle growth in patients with POI. Methods: Using an ultrasensitive enzyme-linked immunosorbent assay (ELISA) kit, we found very low serum AMH levels in patients with POI. We assessed the follicle growth of each patient during each cycle to clarify the usefulness of measuring serum AMH levels for predicting follicle growth in patients with POI under hormone replacement therapy (HRT). Results: A total of 91 cycles of 19 patients with POI were analyzed in this study. Five patients presented with positive serum AMH levels during the observational periods, and all five experienced follicle growth. Only two of the 14 patients with negative serum AMH levels had follicle growth. Serum AMH and follicle-stimulating hormone (FSH) levels in cycles with follicle growth were significantly higher than in cycles without follicle growth. The median serum AMH level (2.77 pg/mL; 25th, 75th percentiles: 0.0, 9.64) in cycles with follicle growth was lower than the lower limit of detection of conventional AMH ELISA kits. The positive predictive value of positive serum AMH levels for follicle growth was higher than that of FSH (< 10 mIU/mL).Conclusions: Measurement of very low levels of serum AMH using picoAMH assays is useful for prediction of follicle growth in patients with POI under HRT conditions. Trial registration: UMIN-CTR UMIN000029464. Retrospectively registered on April 4, 2018. https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000033550

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